CIPN
Figure 1: Morphologic correlates of CIPN. The DRGs can be the target of cumulative neurotoxicity as in platinum compounds. Axons, rarely the myelin, can be damaged. At the neuromuscular transmission site (NMT), the acute toxicity of oxaliplatin occurs. Unmyelinated fibers and terminal nerve arbors are the sites of acute taxane toxicity. An additional spinal mechanism at the alpha-2-delta-Typ1 subunit in neuropathic pain is assumed.


Keywords: CIPN,  scheme

Cisplatinum neuropathy
Figure 2: Cisplatinum neuropathy. Clinical and electrophysiological features of a 40-year-old male with an ataxic cisplatinum neuropathy. (a) Despite numbness and sensory ataxia no motor involvement with normal small-hand muscles. Nerve conduction velocity (NCV) measurement shows normal motor NCV, (b) the sensory NCV is reduced to 1 uV (pathologic). (c) The feet appear normal, neither atrophy nor trophic changes can be seen. (d) Knee-to-shin is pathologic, vibration perception is absent. (e) Motor NCVs of peroneal nerves are normal. The sural nerve sensory potential is absent; (f) the F wave is normal.


Keywords: ataxic cisplatinum neuropathy,  clinical features

Nerve Roots
Figure 3: Autopsy of the nerve roots, cauda equina and posterior columns of a 74-year-old woman with breast cancer and suspected meningeal carcinomatosis. She received several cycles of intrathecal cytosine arabinoside (Depo-Cyt®). The myelin appears blue with a Klüver staining. (a) Cauda equina. The nerve roots show loss of myelin with a patchy damage to nerve fascicles. (b) Spinal thoracic nerve. Diffuse demyelination. (c) Spinal cord and posterior column: Diffuse loss of myelinated fibres, ballooned degeneration of myelinated fibres.


Keywords: cauda equina,  nerve roots,  posterior column,  spinac thoracic nerve,  spinal cord